OBJECTIVES: To investigate the predictors and impact on long-term survival of one chronic total occlusion (CTO) or multiple CTOs in patients presenting with ST-elevation myocardial infarction (STEMI). DESIGN: Single-centre retrospective observational study. SETTING: University-based tertiary referral centre. PATIENTS: Between 2006 and 2011, a total of 2020 consecutive patients referred with STEMI were categorised into single vessel disease, multivessel disease (MVD) without CTO, with one CTO or with multiple CTOs. INTERVENTION: Primary percutaneous coronary intervention. MAIN OUTCOME MEASURE: The primary end-point was the 1-year mortality. RESULTS: The prevalence of single vessel disease, MVD without CTO, with one CTO or with multiple CTOs was 70%, 22%, 7.2% and 0.8%, respectively. Independent clinical predictors for the presence of CTO were cardiogenic shock (OR 5.05; 95% CI 3.29 to 7.64), prior myocardial infarction (OR 2.06; 95% CI 1.35 to 3.09), age >65 years (OR 1.94; 95% CI 1.40 to 2.71) and history of angina (OR 1.94; 95% CI 1.29 to 2.87). Mortality was worse in patients with multiple CTOs (76.5%) compared with those with one CTO (28.1%) or without CTO (7.3%) (p<0.0001). After adjustment for left ventricular ejection fraction and renal function, MVD was an independent predictor for 1-year mortality (HR: 1.81; 95% CI 1.18 to 2.77, p=0.007), but CTO was not (HR: 1.07; 95% CI 0.66 to 1.73, p=0.78). CONCLUSIONS: Simple clinical factors are associated with the presence of CTO in non-infarct-related artery in patients presenting with STEMI. In these patients, long-term survival was independently associated with MVD, left ventricular ejection fraction and renal function, but not with CTO per se.
OBJECTIVES: To investigate the predictors and impact on long-term survival of one chronic total occlusion (CTO) or multiple CTOs in patients presenting with ST-elevation myocardial infarction (STEMI). DESIGN: Single-centre retrospective observational study. SETTING: University-based tertiary referral centre. PATIENTS: Between 2006 and 2011, a total of 2020 consecutive patients referred with STEMI were categorised into single vessel disease, multivessel disease (MVD) without CTO, with one CTO or with multiple CTOs. INTERVENTION: Primary percutaneous coronary intervention. MAIN OUTCOME MEASURE: The primary end-point was the 1-year mortality. RESULTS: The prevalence of single vessel disease, MVD without CTO, with one CTO or with multiple CTOs was 70%, 22%, 7.2% and 0.8%, respectively. Independent clinical predictors for the presence of CTO were cardiogenic shock (OR 5.05; 95% CI 3.29 to 7.64), prior myocardial infarction (OR 2.06; 95% CI 1.35 to 3.09), age >65 years (OR 1.94; 95% CI 1.40 to 2.71) and history of angina (OR 1.94; 95% CI 1.29 to 2.87). Mortality was worse in patients with multiple CTOs (76.5%) compared with those with one CTO (28.1%) or without CTO (7.3%) (p<0.0001). After adjustment for left ventricular ejection fraction and renal function, MVD was an independent predictor for 1-year mortality (HR: 1.81; 95% CI 1.18 to 2.77, p=0.007), but CTO was not (HR: 1.07; 95% CI 0.66 to 1.73, p=0.78). CONCLUSIONS: Simple clinical factors are associated with the presence of CTO in non-infarct-related artery in patients presenting with STEMI. In these patients, long-term survival was independently associated with MVD, left ventricular ejection fraction and renal function, but not with CTO per se.
Authors: Artur Dębski; Paweł Tyczyński; Maksymilian P Opolski; Mariusz Kłopotowski; Maciej A Karcz; Adam Witkowski Journal: Postepy Kardiol Interwencyjnej Date: 2014-11-17 Impact factor: 1.426
Authors: Seung Woon Rha; Byoung Geol Choi; Man Jong Baek; Yang Gi Ryu; Hu Li; Se Yeon Choi; Jae Kyeong Byun; Ahmed Mashaly; Yoonjee Park; Won Young Jang; Woohyeun Kim; Jah Yeon Choi; Eun Jin Park; Jin Oh Na; Cheol Ung Choi; Hong Euy Lim; Eung Ju Kim; Chang Gyu Park; Hong Seog Seo; Dong Joo Oh Journal: Yonsei Med J Date: 2018-07 Impact factor: 2.759